Post‐Traumatic Avascular Necrosis of the Proximal Humerus
Bibliographic record
Abstract
Displaced fractures of the proximal humerus account for the majority of cases of posttraumatic avascular necrosis (AVN) of the humeral head. The reported rate of AVN is up to 21% following a 3-part fracture, and up to 75% after a 4-part fracture. Accurate Staging of AVN has important implications for determining appropriate treatment. Posttraumatic AVN has been associated with significant functional disability. 78% of cases of posttraumatic AVN required surgical intervention compared to 44% with atraumatic AVN. Advanced disease stage at presentation and extent of humeral head involvement correlated well with progression to shoulder arthroplasty. More than 55% of Stage IV and 79% of Stage V cases required prosthetic replacement at 3 years from diagnosis. Non-arthroplasty treatment options include core decompression and arthroscopic debridement and should be considered in Stages I, II and III of the disease. There is no evidence currently on the safety and efficacy of bisphosphonates in posttraumatic AVN. Hemiarthroplasty and total arthroplasty should be reserved for Stage IV and V AVN.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.020 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".